OBJECTIVETo assess the clinical value of serum complexed prostate-specific antigen(cPSA) in the diagnosis of prostate cancer (PCa).

METHODSSerum samples were obtained from 110 men with untreated benign prostatic hyperplasia (BPH) and 78 men with untreated PCa. The levels of cPSA, total PSA (tPSA) were determined by autoimmunochemistry luminescence method.

RESULTSBoth cPSA and cPSA/tPSA ratio were significantly different between patients with PCa and BPH (P < 0.005), especially, in men with tPSA values between 4.0-10.0 micrograms/L (the diagnostic gray zone). When cPSA/tPSA > or = 0.78 was taken as the cut-off value conjugated with tPSA < or = 10.0 micrograms/L, the sensitivity, specificity, negative predictive value and positive predictive value were as high as 97.8%, 95.8%, 81.9% and 96.5%.

CONCLUSIONSWith the introduction of cPSA and cPSA/tPSA ratio, early diagnosis of PCa by the assessment of tPSA has been made more sensitive and reliable, especially when the tPSA is within the diagnostic gray zone.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; diagnosis ; Prostatic Neoplasms ; blood ; diagnosis

OBJECTIVETo investigate plasma endothelin-1 (ET-1) level in patients with prostate cancers and its clinical significance.

METHODSPlasma ET-1 level was measured by radioimmunoassay in 31 patients of prostate cancer (23 with non-HRPC, 8 with HRPC) and 26 patients of BPH.

RESULTSCompared with each other of the ET-1 level, there were no significant difference among the BPH group,non-HRPC group and HRPC group. No significant difference was found either between bone metastasis (BM) and non- BM, between high and middling differentiation prostate cancer group, as well as in different PSA level groups (P >0.05). But the ET-1 level in low differentiation prostate cancer was notably lower than those of the high and middle respectively (P < 0.05).

CONCLUSIONTo detect plasma endothelin-1 (ET-1) level is not a useful method to evaluate the development and the prognosis of prostate cancer.

Aged ; Aged, 80 and over ; Endothelin-1 ; blood ; Humans ; Male ; Prognosis ; Prostatic Hyperplasia ; blood ; Prostatic Neoplasms ; blood ; Radioimmunoassay

OBJECTIVETo evaluate two-dimensional gel electrophoresis (2DGE) and mass spectrometry in the studies of the serum proteins expressed in patients with BPH and those with high-grade prostatic intraepithelial neoplasm (HGPIN).

METHODSWe extracted serum proteins from BPH and HGPIN patients by 2DGE and cut the differentially expressed interesting protein spots from the gel. Then we digested the proteins, obtained the peptide mass fingerprint by mass spectrometry and identified the proteins through database retrieval.

RESULTSWe successfully achieved the 2DGE maps of the serum proteins from the BPH and HGPIN patients, obtained 1 421-1 532 protein spots from the 2D map of HGPIN and 1 466-1 778 from that of BPH. Based on peptide mass fingerprinting, 9 of the protein spots were identified. Serum amyloid A was found to be expressed in the HGPIN group, but weakly or not at all in the BPH.

CONCLUSIONProteomics can be applied to the study of the serum proteins in BPH and HGPIN patients. It can afford experimental evidence for the early diagnosis and development HGPIN, promote the search of functional and specific proteins of prostate diseases and shed new light on the network mechanisms of the problems.

Blood Proteins ; analysis ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Male ; Mass Spectrometry ; Prostatic Hyperplasia ; blood ; Prostatic Intraepithelial Neoplasia ; blood ; Prostatic Neoplasms ; blood ; Proteome ; analysis ; Proteomics ; methods

A review of serum prostate-specific antigen (PSA) values from January 1994 to May 1997 and their correlation with the histopathology of prostate specimens was carried out in the Department of Pathology, Port Moresby General Hospital. The study has shown that this biochemical investigation has not been properly used for the maximum benefit of the patient population. Remedial measures are suggested to improve the sensitivity and specificity of PSA in a setting with limited resources.
Aged ; Humans ; Male ; Middle Aged ; Papua New Guinea ; Prostate-Specific Antigen - blood ; Prostatic Hyperplasia - blood

OBJECTIVETo identify the differential expressions of serum cytokines between prostate cancer (PCa) and benign prostatic hyperplasia (BPH), and provide proteomic evidence for the early diagnosis of PCa.

METHODSWe used human cytokine array to determine the profiles of the serum cytokines obtained from 6 PCa and 6 BPH patients with the PSA level within the grey scale of 4 - 10 ng/ml.

RESULTSWe identified 19 differentially expressed cytokines in the PCa patients, 16 obviously up-regulated, including IL-3, IL-6 and IL-16, and 3 markedly down-regulated, which were Fas/TNFRSF6, TRALR-3 and IGFBP-6. Most of them were involved in such cellular bioprocesses as transcription, proliferation, signal transduction, and apoptosis.

CONCLUSIONThe cytokine antibody assay permits simultaneous measurement of multiple markers in a small volume of serum, and can identify a panel of key cytokines related to the malignant biological behavior of cancer cells. And it helps to find the biomarkers for the early diagnosis, efficacy assessment and prognosis of prostate cancer.

Aged ; Humans ; Interleukin-16 ; blood ; Interleukin-3 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Prostatic Hyperplasia ; blood ; genetics ; metabolism ; Prostatic Neoplasms ; blood ; genetics ; metabolism ; Proteomics

PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.
Azasteroids ; Blood Vessels ; Finasteride ; Hematuria ; Hemoglobins ; Humans ; Hyperplasia ; Microvessels ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Dutasteride

PURPOSE: This study set out to investigate the safety and efficacy of doxazosin treatment in symptomatic patients with benign prostatic hyperplasia(BPH) in Korea. MATERIALS AND METHODS: A total of 237 male patients aged 50 or over with clinical evidence of BPH were enrolled into this 12-week, open, baseline-controlled, dose-response study. A run-in period of 2 weeks placebo treatment was followed by 10 weeks of doxazosin treatment. The initial dose was 1mg per day which, at 2-week intervals, could have been titrated up to 2, 4, or 8mg per day. Efficacy, in terms of International Prostate Symptom Score(I-PSS) and blood pressure(BP), was assessed from Week 6 onwards. RESULTS: A total of 180 patients(mean age 65.3 years) completed the study, with the most common reason for withdrawal being lost to follow-up(35 cases); four patients were withdrawn due to adverse events. Mean I-PSS score was reduced by 48.8%(from 21.5 at baseline to 11 at completion). Subset analysis of normo- or hypertensive patients showed that in the 26 hypertensive patients mean systolic BP was reduced by 12.3%(-19mmHg) and mean diastolic BP by 13.7%(-14mmHg), whereas in normotensive patients the reductions were 4.0%(-5mmHg) and 1.9%(-1.5mmHg), respectively. No differences in I-PSS improvements were seen between these two groups. The effects of age were also investigated and showed no significant differences in the changes in blood pressure for older patients(> or =65 years; n=91 ) compared with younger patients(7.5/5.8mmHg compared with 6.5/5.0mmHg). There were no differences in I-PSS improvement. Twenty eight adverse events were reported by 16 patients, the most commomly reported events being dizziness, postural hypotension, and headache. CONCLUSIONS: The effectiveness and safety of doxazosin in the treatment of BPH was confirmed in this Korean population, with significant improvements in I-PSS regardless of patient age and blood pressure at baseline. The baseline I-PSS was higher than is commonly seen in European populations, indicating a greater disease severity.
Blood Pressure ; Dizziness ; Doxazosin* ; Headache ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Prostate ; Prostatic Hyperplasia*

Since it has shown that the smooth muscle is the dominant cellular constituent of the hyperplastic prostate and outlet obstruction in benign prostatic hyperplasia (BPH) is mediated by sympathetic nerve system via prostatic smooth muscle alpha 1 receptor, various kinds of alpha blocker have been tried in the treatment of BPH with moderate effectiveness. From May 1994 to December, 1994, a randomized placebo-controlled double blind study of long-acting selective alpha 1 blocker terazosin was undertaken to evaluate short-term effects of pharmacotherapy for BPK Of 80 patients with symptomatic BPH who were randomized to receive placebo or terazosin, 42 completed the study. At baseline, the irritative, obstructive and total symptom score (mean+/-SD) were 8.4+/-3.3, 11.8+/-4.9, 20.2+/-7.6 in placebo group and 8.3+/-4.3, 12.1 +4.6, 20.4 +7.3 in terazosin group and the peak and mean urinary flow rate (ml/ sec) were 10.7+/-2.6 and 5.5+/-2.0 in placebo group and 9.8+/-3.6 and 5.1+/-2.1 in terazosin group. After 28 days trial, the irritative, obstructive and total symptom score (mean+/-SD) were 7.4+/-3.8, 9.3+/-5.6, 16.8+/-9.2 in placebo group and 5.2+/-3.6, 6.2+/-4.0,11.4+/-6.6 in terazosin group(p<0.05, p<0.05 and p<0.01) and the peak and mean urinary flow rate (ml/sec) were 11.1+/-5.1 and 5.8+/-3.1 in placebo group and 14.7+/-6.4, 8.0+/-3.9 in terazosin group. (p<0.01 and p<0.01) At least 30% improvement in total symptom score and peak flow rate were observed in 67% (14/21) and 76% (16/21) of patients respectively in terazosin group. The common side effects were mild dizziness in 5(22%) in terazosin group and 1(5%) in placebo group but premature termination was observed in only 2(9%) patients in terazosin group and 1(5%) in placebo group. The mean change in baseline systolic pressure was 2mmHg for normotensive group and 19mmHg for hypertensive group. In conclusion, this study showed beneficial short term result for the safety and efficacy of long acting selective alpha 1 blocker terazosin in the management of symptoms of BPH However, the durability of the safety and efficacy of terazosin needs to be evaluated for longer periods.
Blood Pressure ; Dizziness ; Double-Blind Method* ; Drug Therapy ; Humans ; Muscle, Smooth ; Prostate ; Prostatic Hyperplasia*

A clinical observation was made on 239 cases of benign prostatic hypertrophy, admitted to the Department of Urology, Korea University College of Medicine during the period of 9 years and 8 months from Jan. 1972 to Aug. 1981. Following results were obtained. 1. Amount of residual urine from 10 ml to 1,500 ml with average 304 ml. 2. Hypertension in 35 cases (14.8%)and pulmonary diseases in 29 cases (12.1%)were frequently associated with B.P.H. 3. E.K.G. was performed in 171 cases. Abnormal findings included L.V.H. in 38 cases (22.2%), arrhythmia in 11 cases (6.4%), but normal in 118 cases (69%). 4. In blood chemistry, blood urea nitrogen was elevated in 75 cases (31.4%)and creatinine was elevated in 69 cases (28.9%). 5. The most common endoscopic findings were trabeculation in 214 cases (89.5%), inflammation in 192 cases (80.3%), kissing of lateral lobes in 138 cases (58.7%)and elevated interureteric ridge in 71 cases (29.7%). 6. Methods of operative treatment were T.U.R. in 184 cases, retropubic prostatectomy in 7 cases and suprapubic prostatectomy in 3 cases.
Arrhythmias, Cardiac ; Blood Urea Nitrogen ; Chemistry ; Creatinine ; Hypertension ; Inflammation ; Korea ; Lung Diseases ; Prostatectomy ; Prostatic Hyperplasia* ; Urology

Purpose: This study aimed at evaluating the expected additive blood pressure (BP) lowering effect of vardenafil when administered in the background of chronic alpha1-blocker therapy. Materials and Methods: Patients (n=90) with symptomatic benign prostatic hypertrophy (BPH) and erectile dysfunction (ED) took vardenafil 20mg in the morning following repeated doxazosin gastrointestinal therapeutic system (GITS) 4mg (n=60) or tamsulosin 0.2mg (n=30) HS a day for 30 days. The standing and sitting BP at baseline, before taking the vardenafil and 30 minutes and 1 hour post vardenafil were measured 3 consecutive times. The data were analyzed by Student's t-test (paired), repeated measures of two-way ANOVA, chi-square tests and Pearson correlation analysis. Results: Doxazosin produced a significant reduction in systolic/diastolic BP ( 12.3/ 6.7mmHg), but tamsulosin did not. In the doxazosin group, the average reductions in BP from baseline ( 24.7/ 15.8mmHg) were significantly higher than that for the tamsulosin group ( 14.6/ 7.5mmHg). However, the average BP change was not different in both group ( 12.4/ 9.1mmHg in the doxazosin group and 11.3/ 6.4mmHg in the tamsulosin group) following a single dose of 20mg vardenafil. The higher the BP was at baseline, the more the reduction in BP was in both the doxazosin and tamsulosin groups. Two patients of tamsulosin showed a sitting systolic BP <85mmHg, but they didn't experience dizziness. Conclusions: We recommend starting Vardenafil treatment in the background of chronic aalpha1 blocker therapy, including tamsulosin, with a low dose and to increase the dose by monitoring the BP, particularly for the patients with hypertension.
Blood Pressure* ; Dizziness ; Doxazosin* ; Drug Interactions* ; Erectile Dysfunction* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia* ; Vardenafil Dihydrochloride